Epilepsy: Multiple Subpial Transection (MST)

• What is multiple subpial transection?
• Who is a candidate for multiple subpial transection?
• What happens before multiple subpial transection surgery?
• What happens during multiple subpial transection surgery?
• What happens after multiple subpial transection surgery?
• How effective is multiple subpial transection?
• What are the side effects of multiple subpial transection surgery?
• What risks are associated with multiple subpial transection?

What Is Multiple Subpial Transection?

Multiple subpial transection (MST) is a relatively new treatment for epilepsy that may be an option when seizures begin in an area of the brain that cannot be removed; for example, areas associated with vital brain functions such as movement, sensation, language and memory. MST is based on the fact that normal electrical impulses in the brain generally move in an up-and-down pattern. Seizure impulses, on the other hand, mostly spread in a horizontal (side-to-side) fashion. MST stops the seizure impulses by cutting horizontal nerve fibers in the outer layers of the brain (gray matter), sparing the vital functions concentrated in the deeper layers of brain tissue (white matter).

Who Is a Candidate for MST?

Most people with epilepsy can control their seizures with medication . However, about 20% of people with epilepsy do not experience an improvement in their seizures after taking medication. In some cases, surgery to remove the part of the brain causing the seizures may be recommended.

MST may be an option for people who do not respond to medication and whose seizures begin in areas of the brain that cannot be safely removed. In addition, there must be a reasonable chance that the person will benefit from surgery. MST may be done alone or with the removal of a section of brain tissue (resection). MST also may be used as a treatment for children with Landau-Kleffner syndrome (LKS), a rare childhood brain disorder which causes seizures and affects the parts of the brain that control speech and comprehension.

Suggested Reading by Our Doctors

• Temporal Lobe Resection - Epilepsy: Temporal Lobe Resection surgery for seizures
• Seizure (Epilepsy) - Learn about epilepsy, or seizure disorder. Causes include head injury, trauma, prenatal injury, poisoning, medications, stroke, heart attacks, alcoholism, infection, and more. Symptoms, diagnosis, and treatment information is included in the information.
• Seizures Symptoms and Types - Read about seizure symptoms and types such as generalized, grand-mal, absence, myoclonic, clonic, tonic, atonic, and partial. Symptom listing is included in the information.

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